Zigma Visiting Physician, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ZIGMA VISITING PHYSICIAN, LLC

Practice address

4 N Deer Point Dr
1002
Hainesville, IL 60030

Phone

(847) 946-0198

Fax

(847) 972-6265

NPI assigned

Mar 7, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Evillo M Domingo, M.D.

Title

President

Phone

(567) 224-6045

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569456000000",
    "number": "1093175804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 N DEER POINT DR",
            "address_2": "1002",
            "city": "HAINESVILLE",
            "state": "IL",
            "postal_code": "600303814",
            "telephone_number": "847-946-0198",
            "fax_number": "847-972-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 N DEER POINT DR",
            "address_2": "1002",
            "city": "HAINESVILLE",
            "state": "IL",
            "postal_code": "60030",
            "telephone_number": "847-946-0198",
            "fax_number": "847-972-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZIGMA VISITING PHYSICIAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-07",
        "last_updated": "2019-09-26",
        "status": "A",
        "authorized_official_last_name": "DOMINGO",
        "authorized_official_first_name": "EVILLO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "567-224-6045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.